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DSH050438 HUNTINGTON HOSPITAL (Active)
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Main Details
Name
HUNTINGTON HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050438
Medicare Provider Number
050438
Additional Details
Current Program Status
Active
Registration Date
4/3/2019
Participating Start Date
7/1/2019
Participating Approval Date
6/14/2019
Last Recertification Date
8/30/2024
Contacts
Authorizing Official
Huntington Hospital
Steven Mohr, Senior Vice President & Chief Financial Officer
(626) 397-5555
Primary Contact
Huntington Hospital
Phuc Xuan Mai, Director of Pharmacy
(626) 397-5179
Addresses
Street Address
100 W. California Blvd
Pasadena, CA 91105
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 1/1/2009; terminated on 8/8/2013; Reinstated 7/1/2019.
06/14/2019
site terminated 8/8/13 for failure to meet GPO prohibition requirements
08/05/2013
May 2025
May 2025
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